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Results for “Double Effect Principle”

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PubMed1994

Euthanasia: the Dutch experience.

Although rules about euthanasia have been developed in the Netherlands, euthanasia has not been legalized. We review the historical aspects of euthanasia, its definition and why no distinction is now made between active and passive euthanasia in the Netherlands. The guidelines for euthanasia, in use in the Utrecht University Hospital, are presented and the result of some studies on euthanasia is discussed. Non-treatment decisions were taken in 17.5% of all deaths in 1990 but only 1.8% of all deaths were the result of euthanasia. Life-terminating acts without explicit and persistent request of the patients occurred in 0.8% of all deaths. The most common reasons for requests for euthanasia were loss of dignity in 57%, pain in 46%, distressing mode of dying in 46% and being dependent on others in 33%. Of all medical decisions concerning the end of life 79% related to patients older than 65 years. The guidelines for euthanasia developed in the Netherlands support both patient and physician in the request for euthanasia.

Aged↗
PubMed1991

The theoretical tenability of the doctrine of double effect.

The doctrine of double effect shows that for which the moral agent is responsible, by explicating the relationship between the act directly intended and the consequences of that act. I contend that this doctrine is necessary not only for natural law absolutism, but also for Donagan's Kantianism and for Quinn's revised construal of the doctrine, and even for consequentialism, as bioethical implications of the doctrine make clear. For those who do not accept this necessity, I contend that it is necessary metatheoretically, in order to deal with those moral agents with irreconcilably different notions of the morally good.

Double Effect Principle↗
PubMed1991

Who is entitled to double effect?

The doctrine of double effect continues to be an important tool in bioethical casuistry. Its role within the Catholic moral tradition continues, and there is considerable interest in it by contemporary moral philosophers. But problems of justification and correct application remain. I argue that if the traditional Catholic conviction that there are exceptionless norms prohibiting inflicting some kinds of harms on people is correct, then double effect is justified and necessary. The objection that double effect is superfluous is a rejection of that normative conviction, not a refutation of double effect itself. This justification suggests the correct way of applying double effect to controversial cases. But versions of double effect which dispense with the absolutism of the Catholic tradition lack justification and fall to the objection that double effect is an unnecessary complication.

Bioethical Issues↗
PubMed1991

Reply to Boyle's "Who is entitled to double effect?

I have only minor quibbles with Boyle's presentation of my version of the Doctrine of Double Effect (DDE) (Boyle, 1991). On my view, the extra morally problematic element in cases of direct intention is the subordination of a victim to purposes that he or she either rightfully rejects or (and this is something that I should now wish to add in light of Boyle's criticisms) cannot rightfully accept. In cases of indirect intention the victim is incidentally affected by an agent's strategy, but in cases of direct intention the victim is made part of the strategy. Boyle suggests at one point that this amounts to using the person.... But I do not think the "using" metaphor is always apt in these cases, although it is perhaps helpful in pointing to the objectionable element in direct intention, which in its perfectly general form can be put only more abstractly.... My only other concern with Boyle's exposition of my view involves his use of the expression "intentionally harming"....The discussion there tends to suggest, in contrast to what Boyle has said earlier, that I represent DDE as discriminating between cases of incidental and intentional harming. But this is precisely what I tried to avoid....

Bioethical Issues↗
PubMed1991

Four versions of double effect.

Recent discussions of the doctrine of double effect have contained improved versions of the doctrine not subject to some of the difficulties of earlier versions. There is no longer one doctrine of double effect. This essay evaluates four versions of the doctrine: two formulations of the traditional Catholic doctrine, Joseph Boyle's revision of that doctrine, and Warren Quinn's version of the doctrine. I conclude that all of these versions are flawed.

Abortion, Legal↗
PubMed1991

Further thoughts on double effect: some preliminary responses.

Since the papers in this issue by Alan Donagan, Don Marquis, William Nelson and Warren Quinn raise complex and challenging questions about almost every aspect of my "Who is Entitled to Double Effect", I cannot, in the present context, provide more than preliminary responses to some of the more important issues they raise in the hope that this might contribute to further clarification of the doctrine of double effect (DDE).

Bioethical Issues↗
PubMed1991

Ethical issues in manipulating the human germ line.

This essay examines the arguments for and against working towards the objective of human germ line engineering for medical purposes. Germ line changes which result as a secondary consequence of other well designed and ethically acceptable manipulations of somatic cells to cure an otherwise fatal disease can be seen as acceptable. More serious objections apply to intentional germ line interventions because of the unacceptability of using a person solely as a vehicle for creating uncertain genetic change in his descendants. It is also morally unacceptable to use the promise of future benefit to experiment on fetuses or embryos when other more effective technologies exist to help parents have healthy children. Using new genetic technologies to select desirable genotypes among gametes is less problematic and affords a promising new technique for avoiding intergenerational harms.

Double Effect Principle↗
PubMed1991

Commentary: maintaining the somatic/germ-line distinction: some ethical drawbacks.

Determinations of the ethical acceptability of genetic therapy have relied on several distinctions in attempts to separate ethically acceptable genetic therapy from those possible therapies that could lead to genetic modifications of future human beings. One distinction that has been proposed is that genetic modifications of human somatic cells is ethically acceptable but that germ-line genetics modifications would be ethically objectionable. This paper examines several serious difficulties which call into question the ethical relevance of a somatic/germ-line distinction.

Double Effect Principle↗
PubMed1994

Radical moral disagreement in contemporary health care: a Roman Catholic perspective.

This paper addresses the moral challenges presented by the existence of radical moral disagreement in contemporary health care. I argue that there is no neutral moral perspective for understanding and resolving these challenges, but that they must be formulated and resolved from within the various perspectives that generate the disagreement. I then explore the natural law tradition's approach to these issues as a test case for my thesis.

Attitude↗